<p> </p> <p class="MsoNormal" style="text-align:justify"><b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;mso-bidi-font-family:Calibri;
mso-bidi-theme-font:minor-latin">INTRODUCTION</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;mso-bidi-font-family:Calibri;
mso-bidi-theme-font:minor-latin">: Atrial Fibrillation is one of the most common arrhythmias faced during peri-operative period.AF can be pre-existing, paroxysmal or permanent.AF can be lead to increased peri-operative mortality including stroke, heart failure, sudden cardiac death etc.The precipitating factors of AF like acidosis,electrolyte imbalance,sepsis,hypovolemia,hypotension etc are to be prevented and managed immediately with medical or electrical cardioversion.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify"><b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;mso-bidi-font-family:Calibri;
mso-bidi-theme-font:minor-latin">CASE REPORT</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;mso-bidi-font-family:Calibri;
mso-bidi-theme-font:minor-latin">: Here we report a case of fifty years old male patient with Polycystic Kidney Disease resulting in End Stage Renal Disease since 17years on maintenance Hemodialysis twice per week since 6months,associated Hypertension since last 5years and severe LV Dysfunction with EF-30% since 3months with pre-existing AF posted for elective Nephrectomy under General Anaesthesia.<o:p></o:p></span></p>